Winter slips often cause hidden fractures that are missed early. Learn why detection is delayed and how clinics identify them.

Why “Hidden Fractures” Appear Late After Winter Falls

By MADI-BONE CLINIC — Gangnam (Seolleung Station)

Winter Slips Cause More Injuries Than You Think

Every winter, patients visit our clinic saying,

“I thought the pain would go away, but it didn’t.”

Winter conditions — frozen ground, hidden ice and limited visibility — create the perfect environment for unexpected falls.
While bruises and sprains are common, what many people don’t realize is that some fractures are initially invisible.
These are referred to as “occult fractures” — hidden fractures.

What Is a Hidden or “Occult” Fracture?

A hidden fracture is a break in the bone that is not clearly visible on initial X-ray imaging,
yet causes persistent symptoms.
These often become detectable days or weeks later.
Common sites include:

wrist (especially distal radius and TFCC-related regions)
ankle bones
elbow
hip/pelvis

$Example radiograph showing subtle occult wrist fracture$

Occult fractures are often initially radiographically undetectable.
Occult Fracture Detection Study

Why Winter Falls Lead to Hidden Fractures

Unlike forceful traumatic accidents,
winter slips produce rotational and compressive forces through narrow contact points.
This mechanism often:

creates hairline cracks rather than displaced fractures
damages tendon or ligament support structures simultaneously
produces swelling that masks underlying bone pain

As swelling subsides over days, the fracture becomes more apparent — which is why patients often say,

“It didn’t hurt much at first — but now it’s worse.”

Why Hidden Fractures Are Missed on Initial X-ray

X-rays detect fractures when:

bone lines are displaced
angles change
clear gaps exist

But tiny cortical disruptions — especially in wrists, hips and feet —
are extremely subtle and sometimes radiographically invisible until bone remodeling begins.

For this reason, early CT or MRI are sometimes required if suspicion is high.

Clinical Clues That a Fracture Is “Hidden”

Patients often say:

“X-ray was normal, but I still can’t walk on it.”

We suspect hidden fracture when:

pain persists beyond 1–2 weeks
load-bearing is difficult
localized tenderness remains intense
pain worsens instead of improving

How We Detect Hidden Fractures at MADI-BONE CLINIC

Evaluation typically includes:

mechanism analysis — “how did you fall?”
palpation for pinpoint tenderness
repeat X-ray if symptoms persist
advanced imaging (MRI or CT) when clinically indicated

CT and MRI significantly increase diagnostic accuracy for occult fractures.
Advanced Imaging Study

How Hidden Fractures Are Treated

If detected early, hidden fractures respond very well to:

immobilization
activity modification
shockwave therapy once acute phase passes
exercise therapy for stabilization

Missed fractures, however, may lead to:

malalignment
early arthritis
chronic instability

Early detection truly matters.

Patient Story — “I Thought It Was Just A Sprain”

Many winter fall patients dismiss pain as a sprain.
However, worsening pain during:

driving
putting weight on furniture
walking down stairs

often reveals the hidden injury beneath.

Internal Links — Related Education

Frequently Asked Questions (FAQ)

1. If my first X-ray was normal, should I still worry?

Yes — persistent pain, swelling or weakness warrants re-evaluation.

2. How long does a hidden fracture take to show?

Some become radiographically evident after 2–4 weeks as healing response forms.

3. When should I seek advanced imaging?

If pain limits daily function or persists beyond 1–2 weeks, CT or MRI is recommended.

MADI-BONE CLINIC — Seolleung Station

MADI-BONE CLINIC
3F, 428 Seolleung-ro, Gangnam-gu, Seoul
Seolleung Station Exit 1 — 3 minutes on foot
02-736-2626
⏰ Mon–Fri 09:30–18:30 / Sat 09:30–13:00